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Nicole A Deitrick, LMT
Specialist in Ellenton, Florida
NPI 1184638447

Nicole A Deitrick is a Specialist based in Ellenton, FL. Nicole A Deitrick practices in Ellenton, FL and has the professional credentials of LMT. The NPI Number for Nicole A Deitrick is 1184638447 and holds a License No. MA29664 (Florida).

The current practice location address for Nicole A Deitrick is 909 25Th Dr E, Ellenton, FL and can be reached out via phone at 941-721-4559 and via fax at 941-721-0142.

Location: 909 25Th Dr E, Ellenton, FL, 34222-2053
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184638447
Provider Name
Nicole A Deitrick
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
909 25Th Dr E, Ellenton, FL, 34222-2053
Phone Number
941-721-4559
Fax Number
941-721-0142
Provider Enumeration Date
07/29/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
909 25Th Dr E
City
Ellenton
State
Florida
Zip
34222-2053
Phone Number
941-721-4559
Fax Number
941-721-0142
person
Provider Business Mailing Address Details
Address
909 25Th Dr E
City
Ellenton
State
Florida
Zip
34222-2053
Phone Number
941-721-4559
Fax Number
941-721-0142
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MA29664 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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